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Orthopedic surgeons, orthotists work together to treat Charcot-Marie-Tooth disea

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Orthopedic surgeons, orthotists work together to treat Charcot-Marie-Tooth

disease

http://www.orthosupersite.com/view.aspx?rid=81786

ORLANDO, Fla. — Both surgical and orthotic options can be indicated for ideal

treatment of patients with Charcot-Marie-Tooth disease (CMT), according to

presenters at the 2011 Annual Meeting and Scientific Symposium of the American

Academy of Orthotists and Prosthetists.

Patients with CMT ultimately benefit from the use of a multidisciplinary team

because of the separate and specific roles that orthopedic surgeons and

orthotists play in their treatment. F. Conti, MD, director of the

division of foot and ankle surgery at Allegheny General Hospital in Pennsylvania

and associate professor of orthopedic surgery at Drexel University College of

Medicine, said he appreciates working with orthotists for that reason.

E. Shy, MD, neurology specialist at Harper University Hospital in

Detroit and professor of neurology at Wayne State University School of Medicine,

provided some background on the disorder. He noted that there are 40 genes that

can cause inherited neuropathies, and studies show that up to 10% of the

population has a peripheral neuropathy. CMT is one of the genetic disorders, and

can be traced directly to its source in many instances.

Given this information, Shy said that patients and their families want to know

who else in their family is at risk.

" It matters to families, knowing the [likelihood of] inheritance for CMT, " he

said.

Responding to audience questions, Conti said that, as orthotists, the patient's

ultimate diagnosis is irrelevant to the treatment.

" You don't need the diagnosis, " he said. " You need the technical diagnosis. "

McKale, CO, LO, practice manager of Midwest Orthotic and Technology Center

in Chicago and Merrillville, Ind., agreed, saying, " The diagnosis is almost

unimportant. "

He urged orthotists not to get caught up in that aspect of treatment and,

instead, provide the patient with the best device and care possible.

" We need to be concerned with the overall picture of the person and what we're

seeing when we're treating these patients, because ultimately the decisions we

are making as orthotists affect the outcome, " he said. " If we're not making the

proper decisions then that outcome is not going to be what the patient wants and

the brace is going to get thrown on the shelf. "

Making the decision for surgical options also affects the use of orthoses.

Treating a patient at the level of early supple deformity might indicate trying

orthotic intervention as the best option. However, a patient at the same level

also might be the best candidate for tendon transfer surgery to rebalance foot,

Conti said.

Another benefit of surgery, he said, is that it might not completely eliminate

the need for an orthosis, but downgrade the level of orthosis necessary for

treatment.

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